Healthcare Provider Details

I. General information

NPI: 1407779903
Provider Name (Legal Business Name): PATRICIA STOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31240 AVENIDA MARAVILLA
CATHEDRAL CITY CA
92234-2790
US

IV. Provider business mailing address

31240 AVENIDA MARAVILLA
CATHEDRAL CITY CA
92234-2790
US

V. Phone/Fax

Practice location:
  • Phone: 559-991-3133
  • Fax:
Mailing address:
  • Phone: 559-991-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: